Program Operations Manual System (POMS)

A. Policy for the scope of an application

The scope of an application is the range of benefits covered by an application under:

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Title II (retirement, survivors, and disability benefits),

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Title VIII (Special Veterans Benefits),

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Title XVI (Supplemental Security Income), and

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Title XVIII (Medicare Part A).

Unless a claimant restricts the scope of his or her application, the application will
generally cover all classes of benefits on all Social Security numbers (SSN), for
which the claimant is eligible, regardless of the application’s title. For example,
an application for widow(er)’s benefits can serve as an application for retirement
benefits. For scope of the application exceptions see GN 00204.020B.5 in this section. Interviewers must explore potential entitlement to another class
of benefits or entitlement on another earnings record. If a claimant is eligible for
additional benefits, we may require a supplemental application to obtain additional
information. If a claimant does not want the additional benefits, he or she may possibly
have the option to restrict the scope of the application to exclude a specific benefit.
The claimant must restrict the scope of his or her application prior to adjudication.

B. Benefits covered by an application

1. Title II Social Security Application

An application for one benefit under Title II (for example retirement) serves as an
application for all benefits that the claimant is eligible under Title II and Title
XVIII (for example, widow(er)’s, spouse’s, disability, and Medicare Part A). An application
for survivor benefits under Title II also serves as an application for:

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Survivor benefits under the Railroad Act; and

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Survivor benefits through the Department of Veterans Affairs (DVA). For the policy
and effect on the DVA application process when an SSA life claim converts to a survivor
claim, see the note in RS 01702.410A.

NOTE: An application for benefits as a widow(er), mother or father can serve as an application
for the Lump Sum Death Payment (LSDP).

2. Title VIII Special Veterans Benefits (SVB) Application

A Title VIII SVB application is also an application for Title II and Title XVI benefits.
For the scope of an SVB application, see VB 00201.010D.1.

3. Title XVIII, Medicare Part A Application

An application for Medicare Part A is a retirement application that has been restricted
to cover Medicare only. The instructions for abbreviated retirement applications are
in GN 00204.009D.

NOTE: For information on the validity and scope of an iClaim Medicare-only application,
see GN 00204.059K.2.

4. Title XVI Application, Supplemental Security Income (SSI)

An SSI application may serve as an application for the following benefits:

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Title II,

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Title XIX Medicaid,

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Federally administered State supplementation, and

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Title VIII, Special Veterans Benefits.

For more information on the scope of a Title XVI application, see SI 00601.010D1.

5. Scope of the application exceptions

We determine the scope of an application by the wording we include at the beginning
of the application. Applications under Titles II, VIII, XVI, and XVIII (Part A) contain
an introductory paragraph that covers all classes of benefits for which the claimant
is eligible. This includes all SSNs, regardless of the title of the application.

However, there are some exceptions to the scope of benefits covered by an application.
They are as follows:

a. Application for Lump Sum Death Payment (SSA-8-F4)

In February 1978, the SSA-8-F4 was limited to benefits on the deceased number holder’s
(NH)'s SSN. Prior to February 1978, the scope of the application was for all Title
II benefits, (including Disability Insurance Benefits (DIB)), that the claimant may
have been entitled based on any earnings record.

b. Oral inquiry for SSI

Title II and Title XVIII applications are not applications for Title XVI. However,
an application for Title II can serve as an oral inquiry for SSI. For the policy that
explains the criteria for an oral inquiry for SSI, see SI 00601.025.

c. Application for SVB

A Title VIII application is not an application for Title XVIII (Part A).

Title II and XVI applications are oral inquiries for Title VIII.

6. When we require separate applications

Although one signed application establishes the claimant's application date for all
benefits within the scope of the application, in some situations we obtain more than
one application for record keeping purposes or due to systems limitations.

C. Scope of the application examples

John, age 64, files an application for RIB. He states that his wife died. The RIB
application covers widower's benefits and the LSDP on his wife's SSN.

2. Application for Lump Sum Death Payment (LSDP) (Form SSA-8-F4)

James, age 62, files an application for the LSDP on his deceased wife's account. The
LSDP application covers widower's benefits on the deceased NH’s record but does not
cover RIB on his own SSN.

D. Policy for restricting the scope of the application

When a claimant is eligible for more than one benefit at the time of filing, he or
she may, for any reason, choose to limit or restrict the scope of the application
to exclude a class of benefits unless there is an exception. The reason may be to
receive higher current benefits or to maximize the amount of benefits over a period-of-time,
including the effect of delayed retirement credits (DRC). For additional information
on DRCs, see RS 00615.690.

NOTE: The claimant must restrict the application prior to adjudication.

1. Exceptions for restricting the scope of the application

a. Hospital Insurance (HI) (Medicare Part A) filing

A claimant who is age 65 or older must file for HI if filing for any monthly benefit.
Refer to HI 00801.022 for additional information on application retirements for HI.

b. Deemed filing rule

A claimant who is eligible for both RIB and spouse’s (AUXSPO) benefits must apply
for both and cannot restrict his or her application to only one benefit when he or
she:

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is born January 2, 1954 or later and eligibility for both benefits exists in any month,
or

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is born before January 2, 1954, under full retirement age (FRA), and eligibility for
both benefits exists in the first month of entitlement (MOET) to either benefit.

For more information on the rules for deemed filing, see GN
00204.035.

2. Language for restricting the scope of the application

The claimant may restrict the scope of the application with an unequivocal statement
such as:

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“I filed on (DATE) for all benefits for which I may be eligible except ___________”; or

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“I wish to exclude ________ benefits from the scope of this application.”

Qualifying phrases such as “at this time” or he or she plans to file in the future
are not acceptable.

3. Restricting the scope of an application for Widow(er)’s Insurance Benefits (WIB)

a. Eligible for WIB on more than one record

When a widow(er) is eligible for WIB on more than one record, the widow(er) has the
option to restrict the scope of the application to one record and delay filing for
WIB on the other record(s) so that he or she may receive a higher benefit at a later
date. If the widow(er) does not restrict the application, he or she will be technically
entitled on all other records on which he or she is eligible. For additional information
regarding a widow(er)’s eligibility on more than one record see RS 00615.301A.1.

b. Eligible for auxiliary and survivor benefits

An application for survivor benefits serves as an application for auxiliary benefits
within the 6 month retroactive period (or to month of death) and up to the 12 month
retroactive period for prior disabled number holders (NH). For example, where a NH
was last entitled to a RIB or DIB prior to death, a survivor may be entitled to retroactive
auxiliary benefits if he or she does not restrict the scope of the application and
meets all the factors of entitlement.

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Protective filing: The MOET for the auxiliary benefits may extend past the 6 or 12-month retroactive
period due to a protective filing.

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Deemed filing: The MOET for spouse’s or divorced spouse’s benefits may extend past the 6 or 12-month
retroactive period if the widow(er) is deemed to have applied for spouse’s benefits.

4. Restricting the scope of an SSI application

An SSI application is also an application for Title II benefits. A claimant may choose
to limit the scope of an SSI application to exclude Title II benefits. You must inform
an SSI claimant that restricting Title II benefits will affect his or her eligibility
to receive Title XVI payments. If the claimant chooses not to file after we notify
him or her of potential entitlement to Title II benefits, follow the instructions
in SI 00510.001B.6 and SI 00510.020. Also, if the claimant is a DWB, follow the instructions in HI 00801.154 and DI 11015.005 for counting months of SSI eligibility toward the 5-month waiting period, and the
24-month qualifying period for Medicare.

E. Procedure for restricting the scope of an application

The claimant may restrict the application by answering certain questions on an application
or by signing an unequivocal statement. For examples of unequivocal statements, see
GN 00204.020D.2 in this section.

Record the claimant’s statement to restrict the scope of the application on the RMKS
screen of MCS so that we capture it under the claimant’s signature or attestation.

1. Restricting a WIB claim to exclude RIB

When a claimant files for WIB and wants to exclude RIB from the application, he or
she must answer “No” to the question “If claimant is filing as a surviving spouse,
is the claimant filing for benefits on own record?” on the Additional Benefits (ADDB)
screen. MCS will generate the following statement on the application summary:

“I do not want this application to be considered an application for retirement benefits
on my own earnings record.”

2. Restricting a WIB claim to exclude WIB on a different record

When a widow(er) is eligible for WIB on more than one record and wants to restrict
the scope of the application to WIB on one record, you must include an unequivocal
statement on the remarks section of the application.

3. Restricting a RIB claim to exclude DIB

When an RSI claimant is disabled, determine if he or she wants to exclude DIB from
the scope of the application, follow the procedures for developing entitlement for
DIB in GN 00205.035.

A widow(er) or surviving divorced spouse may wish to exclude a reduced RIB from the
scope of the application and defer filing for an unreduced RIB because of the benefit
increases payable after FRA because of DRCs. See RS 00615.690 for more information on DRCs.

a. Statement to restrict the scope

When a widow(er) or surviving divorced spouse wishes to exclude RIB from the scope
of his or her application, you must obtain an unequivocal statement to exclude the
RIB, such as:

“I do not wish this application to be considered an application for retirement benefits
on my own earning’s record.”

MCS will generate this statement onto the application summary when the response is
“No” to the question:

“If claimant is filing as a surviving spouse, is claimant filing for benefits on own
record?”

This question is located on the Additional Benefits (ADDB) screen. For more information
on the ADDB screen, see MS MCS 005.012C.

b. Notices

Include the paragraph Future Benefits – Own Retirement Benefit (universal text identifier
(UTI) FOB003), on the award notice advising the claimant to contact SSA upon attainment
of FRA. At that time, the interviewer should review and explain the question of unreduced
RIB entitlement and DRCs. For the text to include for this paragraph, see NL 00725.005B. For instructions on adding notice language for initial awards, see MS MCS 009.010
Notice 3 (NOT3).

5. When the MCS claim is for the benefit to be excluded

a. Claim completed but not signed

Delete the unsigned MCS claim per MCS 017.002 if the claimant later decides to restrict the scope of the application.

b. Claim completed and signed but not adjudicated

Manually clear (MANCLR) the claim by following the instructions in MCS 020.004. Use this procedure only if a claim was erroneously established before the restriction
of the application. Document the reason for manually clearing the claim on the RPOC
or DW01 screen.

c. Claim adjudicated

Process a withdrawal in accordance with GN 00206.000. A withdrawal is not always in the best interest of an individual because the claimant
forfeits all rights flowing from the application. In addition, a subsequent application
may not cover the same retroactive period.

d. Claim filed on the internet (iClaim) but NOT adjudicated

When the technician establishes an iClaim RIB application on MCS before identifying
the claimant’s intent to file for AUXSPO benefits only, the technician must:

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MANCLR the erroneously propagated RIB claim,

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Document the reason on the RPOC screen in MCS, and

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Subsequently establish the AUXSPO claim on MCS.

For instructions on establishing a new claim and manually clearing the iClaim refer
to GN 00204.055H.3.b.

6. Restricting the scope of an iClaim application

When eligible, a claimant can restrict his or her iClaim application to spouse’s benefits
only by answering, “Yes” to the iClaim question: “If you are eligible for both retirement
benefits and spouse’s benefits, do you want to delay receipt of retirement benefits?”
Therefore, you do not have to type a statement on the RMKS screen in MCS. The claims
specialist (CS) must re-contact the claimant to discuss delaying RIB for AUXSPO and
document the discussion on the RPOC screen. To see how the information from iClaim
propagates to MCS refer to GN 00204.055.